Primary systemic chemotherapy (PSC) in breast cancer prolongs disease-free survival in patients who have obtained pathological complete remission (pCR).In combination with pathological examination, CT and MRI have been used to evaluate the efficacy of PSC, they generally coincide well with pathological evaluation.We here present two cases showing discrepancies between pathological examination and imaging analysis after PSC in breast cancer.We should keep such discrepancies in mind to determine the ideal treatment after PSC.An accurate method of evaluating cellular damage by PSC is needed.
Although many modalities have been established to diagnose breast cancers, it is sometimes difficult to reveal nonpalpable cases.Duct lavage cytology was originally established to reveal groups at high risk for breast cancers by detecting metaplastic ductal cells. We report here a case where duct lavage was useful for revealing a small cancer that had been undetected by repeated bloody nipple discharge and cytological examinations. Duct lavage cytology may be of use in cases where nipple discharge of unknown origin persists.
A preoperative tumor guiding system for nonpalpable breast cancer using a VATS guiding needle (Hakko Co., Ltd., Tokyo Japan) was reported.It was easy to introduce the guiding needle into breast cancers smaller than 1cm under ultrasonographic observation. Neither bleeding nor infection was experienced. Wound management was easy and painless. This guiding system is very useful for locating and managing nonpalpable breast cancers even in outpatient settings.